Serum trace elements in patients with gestational diabetes

Diabetes mellitus is characterized by hyperglycemia and is closely related to trace elements. Quite a few pregnant women suffer from impaired glucose tolerance [IGT] or gestational diabetes mellitus [GDM. Investigation of the changes of trace elements contents in the serum of the pregnant women with GDM is significant in the etiological research and cure of the diseases. The study carried out in Al Kadhmiya Teaching Hospital in Baghdad from January 2004 to December 2004 on twenty pregnant women whom their pregnancies were complicated by gestational diabetes. Levels of trace elements such as selenium [Se], copper [Cu], iron [Fe], zinc [Zn], chromium [Cr], magnesium [Mg] and manganese [Mn] were measured in their blood serum by using atomic absorption spectrophotometer and compared with 20 healthy pregnant women. Maternal serum levels of selenium and manganese were significantly decreased in women with gestational diabetes mellitus. Zinc and chromium levels were not significantly decreased, while magnesium level was increased significantly in women with gestational diabetes, copper and iron levels are not changed. Trace elements are essential materials for human body, and play a role in pregnancy complicated by gestational diabetes. Dietary supplements of certain trace elements may decrease occurrence of gestational diabetes and its complications to the mother and her fetus

Endometrial receptivity in clomiphene citrate therapy for polycystic ovarian syndrome assessment by serum and endometrial tocopherol and superoxide dismutase as markers

Endometrial receptivity is determined by mediators of implantation produced by the endometrium and the embryo. Different markers of this receptivity are studied. Oxidative stress causes endothelial dysfunction thus hypoxia. As one ultrasonic feature of polycystic ovarian syndrome patients treated with clomiphene citrate is thin endometrium and low vascularity we assume that this hypoxia may have a relation to oxidative stress. To investigate the antioxidants, serum and endometrial tocopherol and superoxide dismutase, as possible markers of endometrial receptivity in clomiphene citrate treated polycystic ovarian syndrome patients and their correlation with other markers. A prospective controlled study was carried out in AI-Kadhmyia teaching hospital, AI-Nahrain University for the period, Dec 1[st] 2001- July 31[st] 2002. The study group G-A included 62 polycystic ovarian syndrome patients further sub-divided to G-A 1, 33 patients who ovulated when given clomiphene citrate therapy; G-A2: 29 patients on no clomiphene citrate therapy. The control group G-B included 20 women with sub-fertility due to pure male or tubal factor with no polycystic ovarian syndrome. At mid-luteal phase of the cycle determination of serum progesterone, serum and endometrial tocopherol by high performance liquid chromatography and superoxide dismutase by spectrophotometry were performed. Both tocopherol and superoxide dismutase in serum and endometrium were the lowest in patients with untreated polycystic ovarian syndrome. higher in clomiphene citrate polycystic ovarian syndrome and the highest in the control. Highly significant reduction of endometrial tocopherol in both polycystic ovarian syndrome groups in comparison to serum tocopherol [p=0.008 and 0.006] while such serum and endometrial gradient was not present regarding superoxide dismutase [p=0.053 and 0.38]. Other markers of endometrial receptivity, as obesity, serum progesterone, LH and testosterone, had no significant correlation with tocopherol and superoxide dismutase in polycystic ovarian syndrome. Antioxidant level is not related to other markers of endometrial receptivity. So serum as well as endometrial tocopherol and serum but not endometrial superoxide dismutase is suggested to be new biochemical markers of endometrial receptivity. We may suggest clinical trial studies about Vitamin E [alpha-tocopherol] supplement to polycystic ovarian syndrome patients to improve endometrial receptivity and possibly the success rate in reproductive treatment of polycystic ovarian syndrome

Maternal serum creatine Kinase and single serum progesterone measurement as predictors of ectopic pregnancy

To evaluate the role of maternal serum creatine kinase and single serum progesterone measurements in the prediction of ectopic pregnancy. The study was conducted at A-Khadhimya Teaching Hospital, department of obstetrics and gynecology during the period from March 2001 through April 2002. The study included 60 women divided into 3 groups: Group A: Twenty patients with ectopic pregnancy confirmed by surgery and histopathology. Group B: Twenty patients with non continuing pregnancy [missed abortion or spontaneous abortion] of comparable gestational age. Group C: Twenty women with normal intrauterine pregnancy of comparable gestational age. The following laboratory measurements for the studied groups were done: serum age. The following laboratory measurements for the studied groups were done: serum creatine kinase, serum progesterone levels and histopathological study to determine the depth of invasion of the trophoblast to the muscular layer of the fallopian tube for group A. The mean serum creatine kinase was significantly higher in group A than in groups B and C [P<0.0001] and the mean serum progesterone level was significantly lower in groups A and B than in group C [P<0.0001]. The mean serum creatine kinase level was significantly higher in ruptured ectopic pregnancy than in the unruptured [P<0.0003], and in isthmic than in ampullary ectopic pregnancy [P<0.007]. In addition, the mean serum progesterone level was significantly higher in ruptured than in the unruptured ectopic pregnancy [P<0.01]. There was a significant positive correlation between serum creatine kinase and progesterone level in group A. There was an increase in the serum creatine kinase levels accompanying muscular damage in ectopic pregnancy probably antedates tubal rupture and could help in discriminating ruptured from unruptured ectopic pregnancy. The combined use of both serum creatine kinase and serum progesterone in patients with suspected ectopic pregnancy has a higher differential accuracy than either analysis alone